Findings and prognostic value of lung ultrasound in COVID-19 pneumonia [article]

Jorge Castelao, Desirée Graziani, Joan B Soriano, José Luis Izquierdo, Collaborative Working Group COVID Pulmonology Guadalajara
2020 medRxiv   pre-print
Objectives: The aim is to systematically describe the findings of lung ultrasound in patients with COVID-19 pneumonia and to analyze its prognostic value. Methods: Lung ultrasound was performed to 63 patients with COVID-19 pneumonia admitted to a University Hospital. Lung involvement was evaluated using a 4-point scale with a 12-area pulmonary division (lung score -LS-). Ultrasound findings, along with clinical characteristics, were recorded. Results: All patients showed ultrasound involvement
more » ... n at least 1 area (mean 8 ± 3.5). Total LS was 15.3 ± 8.1, without differences between left and right lung. Most affected regions were the lower one (95.2%) and the posterior one (73.8%). Total LS showed a strong correlation (r = -0.765) with PaO2/FiO2; by lung regions, those with a higher correlation were the LS of the anterior one (r = -0.823) and the LS of the upper one (r = -0.731). 22.2% of patients required non-invasive respiratory support (NIRS). Multivariate analysis shows that anterior region LS, adjusted for age and sex, is significant (odds ratio 2.159, 95% confidence interval 1.309 to 3.561) for the risk of requiring NIRS. Anterior region LS ≥ 4 and total LS ≥ 19 have similar characteristics to predict the need for NIRS. Conclusions: Ultrasound involvement in COVID-19 pneumonia is bilateral and heterogeneous. Most affected regions are the posterior and the lower ones. The anterior region has prognostic value, because its involvement strongly correlates with the risk of requiring NIRS, and an anterior region LS ≥ 4 has high sensitivity and specificity for predicting the need for NIRS.
doi:10.1101/2020.06.29.20142646 fatcat:n6lz6zcy2ndsfbirpwljrrpzqe